| Entity Name: | BIG SMILES FLORIDA, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 24 Jun 2024 (8 months ago) |
| Document Number: | P24000042653 |
| Address: | 122 W PINE ST, SUITE 300, ORLANDO, FL 32801 |
| Mail Address: | 15458 N. 28TH AVENUE, SUITE A, PHOENIX, AZ 85053 |
| ZIP code: | 32801 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013752690 | 2024-06-26 | 2024-06-26 | PO BOX 41130, PHOENIX, AZ, 850801130, US | 122 W PINE ST STE 300, ORLANDO, FL, 328012649, US | |||||||||||||||
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| Phone | +1 888-833-8441 |
| Fax | 8883739612 |
Authorized person
| Name | PAUL SPURGEON |
| Role | CREDENTIALING SUPERVISOR |
| Phone | 8888338441 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| LEVI, NOAH | Director | 122 W PINE ST, SUITE 300, ORLANDO, FL 32801 |
| Name | Role | Address |
|---|---|---|
| LEVI, NOAH | President | 122 W PINE ST, SUITE 300, ORLANDO, FL 32801 |
| Name | Role | Address |
|---|---|---|
| LEVI, NOAH | Treasurer | 122 W PINE ST, SUITE 300, ORLANDO, FL 32801 |
| Name | Date |
|---|---|
| Domestic Profit | 2024-06-24 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
